Learning The Hard Way
How Adaptive Strategies Hinder Future Success for Those with Down Syndrome
Jennifer Gray, MS, CCC-SLP
1. Learning the hard way:
Young children with Down syndrome develop adaptive strategies that hinder current and future success. Easy and difficult tasks are often avoided and past successes do not lead to future consolidation of skills for improved success (https://library.down-syndrome.org/en-gb/research-practice/01/2/learning-hard-way-avoidance-strategies-young-down-syndrome?_ga=2.187327016.1067879216.1658796451-1201909322.1656700315).
“Every child (including children with Down syndrome) adapts to their environment. Where children with Down syndrome struggle to develop key skills in a typical way, they tend to employ alternative adaptive strategies. Although these strategies can yield immediate benefits, they may restrict the child's later experiences, affecting their developmental trajectory.” https://www.psychol.cam.ac.uk/babylab/embodied-attention-learning/summaries-our-research-parents-and-practitioners-embodied
This has vast implications for learning in school and how avoidance and refusal behaviors are interpreted. Without this knowledge about how children with Down syndrome approach learning, teachers and SLPs resort to dealing with undesired behaviors instead of teaching, thereby removing the child from those learning environments that appear not to work. This makes inclusion extremely confusing.
Students with Down syndrome have difficulty with passive learning (listening). They must be an active participant!
Strategies: Anticipating behaviors and using techniques that hinder the child’s ability to avoid and refuse.
Use what they love: visual materials, not worksheets, music, peers, schedules, video modeling, reading, mastering tasks before moving on, memory games (visual and verbal), let them be the teacher, PREPARE them for what comes next.
2. Difficulty answering questions is bigger than you think: this may be the #1 barrier preventing social communication and determination of knowledge in school. Learning is rooted in active listening and executive functioning prior to assessment of language use. This is a perplexing and VERY common occurrence for those with DS. Getting answers wrong or not answering questions has nothing to do with knowing the answers. For many reasons (including those above), children with Down syndrome do not attend to questions in a way that allows them to hold the question in mind while searching for the answer from memory or in the environment, then planning the expressive language and speech fast enough to answer the question. This is a complex sequence of cognitive steps needed to retrieve information and share it. Many children won’t even attempt it for reasons above and a cycle of failure. I try, it is wrong, I try again, still wrong, act out, forget task, get in trouble, get out of work. Multiple secondary gains are a common result to failed attempts are common and many times we don’t recognize the incidents as failures, so we don’t change our methods.
§ Strategies:
§ Demonstrate how to answer before asking questions.
§ Goals and strategies for “wh” questions should be targeted AFTER lower-level questions are answered consistently. The problem isn’t the understanding and use of “who, what, where, why” but of active listening and verbal short-term memory skills needed to answer any question.
§ Praise effort, identify error, try again: Instead of saying “no”, say “almost, good idea but, I heard …, close, good guess but, that was tricky let’s try again, etc.”
§ Identify level of questions the child can get right and build from there: Start with choice questions; use questions that contain the answer “do you want 2 or 3 fish crackers?”
§ Predict the answer you want and switch the order of choices (do you want juice or water? If the child simply repeats the last item, give them what they say, not what you know they want).
§ Ask yes/no questions
§ Answers should be what a typical child might say: the answer to “what is your name?” should be the child’s first name only; not “my name is Jennifer.”
§ Pair with visuals that give the answer.
3. Speech clarity IS possible: Focusing on articulation as the only speech target will not improve speech clarity over time and the use of alternative communication strategies shouldn’t replace speech practice. Research shows the importance of speech at very young ages as indicators of later language abilities. Speech must be practiced in dosages that approximate the speech practice of typical peers regardless of other expressive language targets. How should school SLPs target the above suggestions given very little time with each student?
Strategies:
· Melodic Intonation Therapy (MIT), modify pitch and loudness, reading words and phrases, imitate the speech rhythm of others, attention to voice and resonance, use fluency/stuttering strategies.
· Practice saying functional words and phrases using a technique that eliminates error patterns of rate, loudness, pitch, rhythm, and fluency that can be incorporated into daily routines for a couple of minutes each day.
· Daily Practice: Say name 5 times using a technique that works (above); greet 5 people during the day (pick a specific activity or time (passing periods, lunch, before and after school, the playground, etc.); use peer models to be the aid or facilitator, round robin in group tasks, use a video model on a phone or iPad, assign as homework, ask teacher(s) to practice a word or phrase during direct instruction, etc. Observe the child’s classroom, lunch hour, and others to find gaps where quick practice can be “squeezed in” or when the teacher could incorporate some repetitions.
· Speech clarity should be determined according to the listener. The goal is for listeners to attend to what is said, not how it is said.
Resources:
1. Down Syndrome Education International: Research, articles, materials, in easy to digest formats.
· https://www.down-syndrome.org/en-us
2. @connectedspeech
